The NHS is duty bound to provide its patients with a high standard of nursing care. But a range of pressures is making this increasingly difficult for a shrinking nursing workforce to provide. An ageing population means more people in hospital, often for longer periods. Patients with multiple, complex conditions require round-the-clock care from a team of dedicated nurses. But fewer nurses attempting to treat growing numbers of patients creates the perfect storm for stress and burn-out.
Today’s student nurses must be equipped with a range of strategies if they are to successfully face these challenges. They must be emotionally and physically resilient while also possessing communication, teamwork and leadership skills. It’s a tall order, but one which has been an addressed at Dundee University with the support of local prisoners and soldiers.
One element of the undergraduate nursing programme is simulation, which requires public volunteers to role-play the part of the patient in realistic practice scenarios. Students work as a team to achieve a successful outcome for the “patient” who, in turn, gives feedback to students on their performance.
Attempting to keep the simulated scenarios as real as possible has proved to be a challenge. As with most volunteer groups, members tend to be elderly retirees. Volunteers from marginalised groups were required in order to make the experience more authentic for students. This is where inmates from the nearby Castle Huntly Prison stepped in to bridge the gap.
Initially, the idea of involving prisoners in an undergraduate nursing programme did raise a few eyebrows but, on closer examination, the rationale for this initiative soon became clear. Research shows that prisoners have poor physical, mental and social health. Many have low education and literacy levels, low levels of employment and may have been in care.
The Castle Huntly volunteers were typical of this group, and they proved to have a wealth of knowledge about complex health needs, experience of poor mental and physical health and experience of being in the NHS system. The prison’s main role is to help prepare offenders for reintroduction back into their communities. This is done by encouraging individuals to take personal responsibility for their own actions and offering opportunities to build “job readiness” through work placements.
Participation in simulation activities quickly became a popular placement with more than 60 prisoners taking part. Prisoners’ roles were initially as actors, but they soon became involved in helping design, deliver and evaluate the simulation activities which included diabetes, sexual health and substance misuse.
Not only were the prisoners supporting the education of student nurses, they were developing their own self-esteem and sense of worth, as one prisoner explained:
When I came back from that session I was on a high. I really enjoyed the day… It’s the first time in years I’ve actually gone out and been a human in that kind of environment … expanding my own knowledge. It’s a good idea.
But it’s not just prisoners getting in on the nurse education experience in Dundee. The local army barracks has also become involved in an the scheme to help build emotional and physical resilience in nursing students.
The 225 Medical Regiment Scotland partnered the university to develop a series of authentic, real-life scenarios which students may face in their future careers. One activity, “exercise team resilience”, is a day-long, outdoor experience which creates the simulated scenario of an earthquake.
Prisoners, keen to retain their involvement, played the part of locals who had been caught up in the disaster. The day aims to develop nursing students’ teamwork and leadership skills, offering an opportunity to develop physical and emotional resilience in a high-stress situation. Feedback from both students and prisoners was positive.
Further exercises were developed and delivered, including “team spirit” and “team endurance” which focused on team building and clinical skills and have been been well received by students, prisoners and soldiers.
Nursing is a rewarding but challenging career, and all staff face many demands in a job that is unlikely to get easier any time soon. But with a more creative kind of approach that looks for alternative ways to teach and provide experience, student nurses should be better equipped for a long, fulfilling career in healthcare. NHS patients deserve nothing less.